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Article(id=1322924099575620546, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.038, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339284080, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339284080, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339284080, creator=13701087609, updateTime=1793339284080, updator=13701087609, issue=Issue{id=1322923782029062261, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='6', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339208371, creator='13701087609', updateTime=1793340556755, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929437859258468, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929437859258469, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=188, endPage=191, ext={EN=ArticleExt(id=1322924099806307268, articleId=1322924099575620546, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Feikang Chuanning Pills（肺康喘宁丸）on Chronic COPD with Prolonged Lung-Kidney Qi Deficiency Syndrome and Its Influence on AKT/mTOR Pathway, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the therapeutic effect of Feikang Chuanning Pills（肺康喘宁丸）on chronic obstructive pulmonary disease（COPD）with prolonged lung-kidney Qi deficiency syndrome and its influence on protein kinase B（AKT）/mammalian target of rapamycin（mTOR）pathway.

Methods

A total of 84 patients with chronic COPD with prolonged lung-kidney Qi deficiency syndrome who were treated in Ningbo Hospital of Traditional Chinese Medicine from May 2021 to May 2023 were selected and divided into conventional group（42 cases）and traditional Chinese medicine group（42 cases）by random number table method.The conventional group was treated with conventional treatment，and the traditional Chinese medicine group was treated with Feikang Chuanning Pills on this basis.TCM syndrome scores，lung function，AKT/mTOR pathway protein，clinical efficacy and occurrence of adverse reactions in two groups were observed.

Result

After treatment，TCM syndrome scores，the levels of AKT，p-AKT，mTOR and p-mTOR in the traditional Chinese medicine group were lower than those in the conventional group（P<0.05）.The levels of forced vital capacity（FVC），forced expiratory volume in 1 second（FEV1），peak expiratory flow（PEF）and FEV1/FVC in the traditional Chinese medicine group were higher than those in the conventional group（P<0.05）.The total effective rate of traditional Chinese medicine group was higher than that of the conventional group（P<0.05）.There was no significant difference in the total incidence of adverse reactions between the two groups（P>0.05）.

Conclusion

Feikang Chuanning Pills can improve the lung function，reduce the TCM syndrome scores，improve the clinical efficacy and reduce the level of AKT/mTOR pathway protein of the patients，with high safety.

, authors=Shuren CHAI, Zheng YANG, Xujin JIA, Xuehong DU, authorsList=Shuren CHAI, Zheng YANG, Xujin JIA, Xuehong DU, authorCompany=null, correspAuthors=Xuehong DU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322924102473884627, articleId=1322924099575620546, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=肺康喘宁丸治疗慢性阻塞性肺疾病迁延期肺肾气虚证的疗效及对AKT/mTOR通路的影响, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

探讨肺康喘宁丸治疗慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）迁延期肺肾气虚证的疗效及对蛋白激酶B/雷帕霉素靶蛋白（protein kinase B/mammalian target of rapamycin，AKT/mTOR）通路的影响。

方法

选择2021年5月—2023年5月就诊的慢性COPD迁延期肺肾气虚证患者84例，采用随机数字表法分成常规组（42例）与中药组（42例）。常规组采用常规治疗，中药组在此基础上给予肺康喘宁丸治疗。观察两组患者的中医证候积分、肺功能、AKT/mTOR通路蛋白水平、临床疗效、不良反应发生情况。

结果

治疗后，中药组患者中医证候积分、AKT、p-AKT、mTOR、p-mTOR水平均低于常规组（P<0.05）；中药组患者用力肺活量（forced vital capacity，FVC）、1秒用力呼气容积（forced expiratory volume in one second，FEV1）、呼气峰流量（peak expiratory flow，PEF）与FEV1/FVC水平均高于常规组（P<0.05）；中医组患者治疗总有效率高于常规组（P<0.05）；两组不良反应总发生率差异无统计学意义（P>0.05）。

结论

肺康喘宁丸能够改善患者肺功能，降低中医证候积分，提高临床疗效，降低AKT/mTOR通路蛋白水平，安全性较高。

, authors=柴树人, 杨征, 贾旭锦, 杜学宏, authorsList=柴树人, 杨征, 贾旭锦, 杜学宏, authorCompany=null, correspAuthors=杜学宏, authorNote=

柴树人（1984-），男，浙江宁波人，副主任医师，硕士，研究方向：中西医结合诊治急危重症。

, correspAuthorsNote=
杜学宏（1966-），男，甘肃张掖人，主任医师，学士，研究方向：中西医结合急危重症救治。
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柴树人（1984-），男，浙江宁波人，副主任医师，硕士，研究方向：中西医结合诊治急危重症。

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柴树人（1984-），男，浙江宁波人，副主任医师，硕士，研究方向：中西医结合诊治急危重症。

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组别例数主证症候积分次证症候积分
治疗前治疗后治疗前治疗后
常规组4212.95±1.489.32±2.33*22.34±3.4713.45±2.56*
中药组4213.06±1.526.27±2.01*22.16±3.417.38±2.49*
t值5.3366.4240.24011.015
P值0.738<0.0010.811<0.001
), ArticleFig(id=1322924107293138945, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924099575620546, language=CN, label=表1, caption=

两组慢性阻塞性肺疾病患者中医证候积分比较（±s）

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组别例数主证症候积分次证症候积分
治疗前治疗后治疗前治疗后
常规组4212.95±1.489.32±2.33*22.34±3.4713.45±2.56*
中药组4213.06±1.526.27±2.01*22.16±3.417.38±2.49*
t值5.3366.4240.24011.015
P值0.738<0.0010.811<0.001
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组别例数FVC/（L）FEV1/（L）PEF/（L/s）FEV1/FVC
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
常规组422.09±0.282.36±0.32*1.52±0.481.75±0.53*4.67±1.655.23±1.42*61.56±8.4968.76±10.27*
中药组422.14±0.272.73±0.41*1.49±0.452.03±0.55*4.67±1.655.23±1.42*61.56±8.4968.76±10.27*
t值0.8334.6100.2952.3760.2444.5500.3052.267
P值0.407<0.0010.7680.0200.808<0.0010.7610.026
), ArticleFig(id=1322924107439939587, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924099575620546, language=CN, label=表2, caption=

两组慢性阻塞性肺疾病患者肺功能比较（±s）

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组别例数FVC/（L）FEV1/（L）PEF/（L/s）FEV1/FVC
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
常规组422.09±0.282.36±0.32*1.52±0.481.75±0.53*4.67±1.655.23±1.42*61.56±8.4968.76±10.27*
中药组422.14±0.272.73±0.41*1.49±0.452.03±0.55*4.67±1.655.23±1.42*61.56±8.4968.76±10.27*
t值0.8334.6100.2952.3760.2444.5500.3052.267
P值0.407<0.0010.7680.0200.808<0.0010.7610.026
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组别例数AKTp-AKTmTORp-mTOR
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
常规组4236.65±4.6832.36±4.53*12.89±2.0710.85±1.82*12.05±1.8810.87±1.51*6.91±0.675.04±0.52*
中药组4236.49±4.7328.23±4.26*12.96±2.118.14±0.94*11.86±1.757.31±0.98*6.95±0.723.61±0.43*
t值0.1564.3040.1538.5740.47912.8160.26413.734
P值0.877<0.0010.878<0.0010.633<0.0010.793<0.001
), ArticleFig(id=1322924107695792133, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924099575620546, language=CN, label=表3, caption=

两组慢性阻塞性肺疾病患者AKT/mTOR通路蛋白比较（±s）

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组别例数AKTp-AKTmTORp-mTOR
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
常规组4236.65±4.6832.36±4.53*12.89±2.0710.85±1.82*12.05±1.8810.87±1.51*6.91±0.675.04±0.52*
中药组4236.49±4.7328.23±4.26*12.96±2.118.14±0.94*11.86±1.757.31±0.98*6.95±0.723.61±0.43*
t值0.1564.3040.1538.5740.47912.8160.26413.734
P值0.877<0.0010.878<0.0010.633<0.0010.793<0.001
), ArticleFig(id=1322924107792261127, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924099575620546, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治愈显效有效无效总有效
常规组426（14.29）16（53.33）8（19.05）12（28.57）30（71.43）
中药组4211（26.19）20（47.62）7（16.67）4（9.52）38（90.48）
χ2值4.941
P值0.026
), ArticleFig(id=1322924107897118728, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924099575620546, language=CN, label=表4, caption=

两组慢性阻塞性肺疾病患者临床疗效比较

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组别例数治愈显效有效无效总有效
常规组426（14.29）16（53.33）8（19.05）12（28.57）30（71.43）
中药组4211（26.19）20（47.62）7（16.67）4（9.52）38（90.48）
χ2值4.941
P值0.026
), ArticleFig(id=1322924107968421897, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924099575620546, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数恶心呕吐腹部不适皮疹瘙痒食欲减退总发生
常规组421（2.38）001（2.38）2（4.76）
中药组422（4.76）1（2.38）01（2.38）4（9.52）
χ2值0.718
P值0.397
), ArticleFig(id=1322924108039725066, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924099575620546, language=CN, label=表5, caption=

两组慢性阻塞性肺疾病患者不良反应发生率比较

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组别例数恶心呕吐腹部不适皮疹瘙痒食欲减退总发生
常规组421（2.38）001（2.38）2（4.76）
中药组422（4.76）1（2.38）01（2.38）4（9.52）
χ2值0.718
P值0.397
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肺康喘宁丸治疗慢性阻塞性肺疾病迁延期肺肾气虚证的疗效及对AKT/mTOR通路的影响
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柴树人 , 杨征 , 贾旭锦 , 杜学宏
中华中医药学刊 | 省级项目平台 2025,43(6): 188-191
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中华中医药学刊 |省级项目平台 2025 , 43 (6) : 188 -191
肺康喘宁丸治疗慢性阻塞性肺疾病迁延期肺肾气虚证的疗效及对AKT/mTOR通路的影响
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柴树人, 杨征, 贾旭锦, 杜学宏
作者信息
  • 宁波市中医院，浙江 宁波 315000
通讯作者:
杜学宏（1966-），男，甘肃张掖人，主任医师，学士，研究方向：中西医结合急危重症救治。
作者简介:

柴树人（1984-），男，浙江宁波人，副主任医师，硕士，研究方向：中西医结合诊治急危重症。

Effect of Feikang Chuanning Pills（肺康喘宁丸）on Chronic COPD with Prolonged Lung-Kidney Qi Deficiency Syndrome and Its Influence on AKT/mTOR Pathway
Shuren CHAI, Zheng YANG, Xujin JIA, Xuehong DU
Affiliations
  • Ningbo Hospital of Traditional Chinese Medicine，Ningbo 315000，Zhejiang，China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.038
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摘要
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目的

探讨肺康喘宁丸治疗慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）迁延期肺肾气虚证的疗效及对蛋白激酶B/雷帕霉素靶蛋白（protein kinase B/mammalian target of rapamycin，AKT/mTOR）通路的影响。

方法

选择2021年5月—2023年5月就诊的慢性COPD迁延期肺肾气虚证患者84例，采用随机数字表法分成常规组（42例）与中药组（42例）。常规组采用常规治疗，中药组在此基础上给予肺康喘宁丸治疗。观察两组患者的中医证候积分、肺功能、AKT/mTOR通路蛋白水平、临床疗效、不良反应发生情况。

结果

治疗后，中药组患者中医证候积分、AKT、p-AKT、mTOR、p-mTOR水平均低于常规组（P<0.05）；中药组患者用力肺活量（forced vital capacity，FVC）、1秒用力呼气容积（forced expiratory volume in one second，FEV1）、呼气峰流量（peak expiratory flow，PEF）与FEV1/FVC水平均高于常规组（P<0.05）；中医组患者治疗总有效率高于常规组（P<0.05）；两组不良反应总发生率差异无统计学意义（P>0.05）。

结论

肺康喘宁丸能够改善患者肺功能，降低中医证候积分，提高临床疗效，降低AKT/mTOR通路蛋白水平，安全性较高。

慢性阻塞性肺疾病  /  迁延期  /  肺肾气虚证  /  肺康喘宁丸  /  肺功能  /  临床疗效  /  不良反应
Objective

To investigate the therapeutic effect of Feikang Chuanning Pills（肺康喘宁丸）on chronic obstructive pulmonary disease（COPD）with prolonged lung-kidney Qi deficiency syndrome and its influence on protein kinase B（AKT）/mammalian target of rapamycin（mTOR）pathway.

Methods

A total of 84 patients with chronic COPD with prolonged lung-kidney Qi deficiency syndrome who were treated in Ningbo Hospital of Traditional Chinese Medicine from May 2021 to May 2023 were selected and divided into conventional group（42 cases）and traditional Chinese medicine group（42 cases）by random number table method.The conventional group was treated with conventional treatment，and the traditional Chinese medicine group was treated with Feikang Chuanning Pills on this basis.TCM syndrome scores，lung function，AKT/mTOR pathway protein，clinical efficacy and occurrence of adverse reactions in two groups were observed.

Result

After treatment，TCM syndrome scores，the levels of AKT，p-AKT，mTOR and p-mTOR in the traditional Chinese medicine group were lower than those in the conventional group（P<0.05）.The levels of forced vital capacity（FVC），forced expiratory volume in 1 second（FEV1），peak expiratory flow（PEF）and FEV1/FVC in the traditional Chinese medicine group were higher than those in the conventional group（P<0.05）.The total effective rate of traditional Chinese medicine group was higher than that of the conventional group（P<0.05）.There was no significant difference in the total incidence of adverse reactions between the two groups（P>0.05）.

Conclusion

Feikang Chuanning Pills can improve the lung function，reduce the TCM syndrome scores，improve the clinical efficacy and reduce the level of AKT/mTOR pathway protein of the patients，with high safety.

chronic obstructive pulmonary disease  /  extension period  /  lung-kidney Qi deficiency syndrome  /  Feikang Chuanning Pills（肺康喘宁丸）  /  lung function  /  clinical effect  /  adverse reaction
柴树人, 杨征, 贾旭锦, 杜学宏. 肺康喘宁丸治疗慢性阻塞性肺疾病迁延期肺肾气虚证的疗效及对AKT/mTOR通路的影响. 中华中医药学刊, 2025 , 43 (6) : 188 -191 . DOI: 10.13193/j.issn.1673-7717.2025.06.038
Shuren CHAI, Zheng YANG, Xujin JIA, Xuehong DU. Effect of Feikang Chuanning Pills（肺康喘宁丸）on Chronic COPD with Prolonged Lung-Kidney Qi Deficiency Syndrome and Its Influence on AKT/mTOR Pathway[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 188 -191 . DOI: 10.13193/j.issn.1673-7717.2025.06.038
正文
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慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是指长期吸烟等因素引起的慢性气道炎症和纤维化，以气流受限和难以逆转的气道阻塞为主要特征[1-2]。COPD的迁延期指病情相对稳定的时期，咳嗽咳痰、胸闷喘息等临床症状减轻，患者呼吸功能不再进一步下降，此时进行积极干预治疗可以帮助控制病情，提高生活质量[3-4]。目前西医治疗方式包括药物治疗、吸入疗法、康复训练和改变生活方式等，能够有效延缓疾病进展，但部分常用药物包括支气管扩张剂和吸入类固醇等长期使用可引起肺部感染、高血压、心律失常等不良反应[5-6]。随着中医学的不断发展，中医药治疗COPD因其独特优势逐渐受到重视，中医理论中，COPD归属“咳证”范畴，肺肾气虚导致气机失调、阻滞是主要发病机制之一，补益肺肾、润肺平喘是其主要治疗原则[7-8]。肺康喘宁丸由黄芪、熟地黄、浙贝母、杏仁等药组成，可补益肺肾气虚、化痰平喘，目前尚未有其用于肺肾气虚型慢性COPD迁延期治疗的相关报道，本研究采用肺康喘宁丸治疗慢性COPD迁延期肺肾气虚证，并观察治疗效果，现报道如下。
1　资料与方法
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1.1　一般资料
选择2021年5月—2023年5月于宁波中医院就诊的慢性COPD迁延期肺肾气虚证患者84例，采用随机数字表法分成常规组与中药组各42例。常规组中男23例，女19例；年龄43～77岁，平均年龄（57.28±5.95）岁；体质量指数18～26 kg/m2，平均体质量指数（22.97±2.56）kg/m2；病程3～12年，平均（7.36±2.14）年。中药组中男22例，女20例；年龄45～75岁，平均（56.64±5.87）岁；体质量指数18～26 kg/m2，平均（23.15±2.63）kg/m2；病程3～13年，平均（7.25±2.09）年。两组基线资料比较无统计学意义，具有可比性（P>0.05）。宁波市中医院医学伦理委员会批准本研究开展。
1.2　诊断标准
1.2.1　西医诊断标准
符合《慢性阻塞性肺疾病诊治指南（2013年修订版）》[9]中慢性COPD迁延期的诊断标准。
1.2.2　中医辨证标准
符合《慢性阻塞性肺疾病中医诊疗指南（2011版）》[10]中肺肾气虚证的辨证标准。主症：咳嗽、喘息、胸闷气短、动则气促、腰膝酸软、神疲乏力；次症：自汗、耳鸣、恶风、易感冒、面目浮肿、夜尿频多、咳而遗溺，舌体胖大有齿痕，舌质淡，苔白，脉沉细弱。
1.3　纳入标准
①符合西医慢性COPD迁延期诊断标准与中医肺肾气虚证辨证标准；②年龄在40～80岁；③1个月内未急性发作者；④依从性强，能完成治疗与检查；⑤患者及家属自愿加入本研究并签署知情同意书。
1.4　排除标准
①合并肺部感染、支气管哮喘、急性支气管炎等其他呼吸系统疾患者；②妊娠及哺乳期妇女；③患有精神疾病、意识不清或沟通障碍者；④对本研究药物过敏者；⑤合并恶性肿瘤、免疫缺陷及其他系统功能严重障碍者。
1.5　治疗方法
常规组给予氧疗、运动锻炼、戒烟等常规方案治疗，给予噻托溴铵吸入粉雾剂（tiotropium bromide powder for inhalation，国药准字：20090279，18μg）治疗，1粒药粉胶囊/次，1次/d，连续治疗3个月。
在常规组的基础上给予中药组肺康喘宁丸口服治疗。方药组成为黄芪15 g，山药12 g，党参12 g，熟地黄15 g，枸杞子9 g，五味子9 g，陈皮9 g，浙贝母15 g，麦冬9 g，杏仁12 g，炙麻黄9 g，白芥子9 g，甘草6 g。将药材研磨成粉后，加蜂蜜调和，制成丸剂，每丸6 g，2次/d，每次2丸，连续治疗3个月。
1.6　观察指标
1.6.1　中医证候积分
分别记录两组患者治疗前、治疗后主证与次证情况，按照等级症状积分法分为无（0分）、轻（2分）、中（4分）、重（6分）；舌质、舌苔、脉象分为有（1分）、无（0分），记录各证候积分。
1.6.2　肺功能
观察两组患者治疗前、后用力肺活量（forced vital capacity，FVC）、1秒用力呼气容积（forced expiratory volume in one second，FEV1）、呼气峰流量（peak expiratory flow，PEF）及FEV1/FVC水平。
1.6.3　蛋白激酶B/雷帕霉素靶蛋白（protein kinase B/mammalian target of rapamycin，AKT/mTOR）通路蛋白
采集两组患者治疗前、后空腹静脉血5 mL，离心后取上清，对患者血清中AKT、p-AKT、mTOR、p-mTOR水平以酶联免疫吸附法进行测定。
1.6.4　临床疗效
①临床症状基本消失，肺功能等指标恢复正常范围属临床控制；②临床症状、肺功能等均明显改善，其他指标值趋近正常属显效；③症状与肺功能有改善，其他指标水平好转属有效；④临床症状、肺功能及其他指标无改善或加重属无效。
1.6.5　不良反应
记录两组患者治疗中不良反应发生的情况。
1.7　统计学方法
使用SPSS 23.0统计学软件。例（%）表示计数资料，应用χ2检验；（）表示计量资料，应用t检验。P<0.05为差异有统计学意义。
2　结果
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2.1　中医证候积分
中医证候积分方面，两组在治疗后均降低，中药组下降幅度大于常规组（P<0.05）。见表1。
2.2　肺功能
治疗后，两组患者FVC、FEV1、PEF与FEV1/FVC水平均升高，中药组高于常规组（P<0.05）。见表2。
2.3　AKT/mTOR通路蛋白
治疗后，中药组患者AKT、p-AKT、mTOR、p-mTOR低于常规组（P<0.05）。见表3。
2.4　临床疗效
中药组患者治疗总有效率高于常规组（P<0.05）。见表4。
2.5　不良反应
不良反应总发生率，两组差异无统计学意义（P>0.05）。见表5。
3　讨论
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COPD是一种慢性、进行性疾病，慢性咳嗽、咳痰是COPD最常见的症状，伴有气短、胸闷、咳血等，COPD多见于40岁以上的中老年人，病情易反复急性发作，治疗难度较大，严重损伤患者肺心功能，具有高病死率等特点[11-12]，因此，探究更为安全、有效治疗手段在缓解期以控制症状与预防加重为原则，降低COPD加重发作的风险对患者而言具有重要意义[13]。中医学认为，COPD属“咳证”范畴，肺肾气虚是常见证型之一，肺主气司呼吸，肺气虚则宣发肃降失司，气机逆乱；肾主水，肾气虚则无力通调全身水液代谢，促生痰饮，二脏相互影响，从而发病。因此，治疗当以补肺益肾、化痰平喘为主要原则[14-17]。
本研究中，中药组患者治疗后中医证候积分降低，肺功能指标升高，且改善幅度与治疗总有效率均高于常规组，表明肺康喘宁丸治疗慢性COPD迁延期肺肾气虚证可有效缓解咳嗽、喘息等临床症状，改善患者肺功能，提高临床疗效。肺康喘宁丸中黄芪归肺、脾、肝、肾经，可补虚益气、升阳固表；山药补中益气、益精生津；党参补益肺气、补血生津；熟地黄补肾滋阴、填精益髓；枸杞子补肝益肾、养血明目；五味子补肾宁心、敛肺止咳；陈皮燥湿化痰、理气和中；浙贝母润肺化痰、软坚散结；麦冬养阴润燥、益肺生津；杏仁通利肺气、止咳平喘；炙麻黄宣肺、止咳、平喘；白芥子理气化痰、止咳平喘、甘草镇咳平喘、益气和中，又可调和药性。诸药合用，共奏补益肺肾、益气化痰、止咳平喘之功[18]。肺肾之气充足，气机调畅，水液代谢正常，症状自然缓解。有现代药理学研究表明，黄芪中所含黄芪多糖、黄芪甲苷等有效物质可具有免疫调节功能，可改善氧化应激与炎症反应，提高COPD模型大鼠肺功能[19-20]；五味子中的活性成分戈米辛A和戈米辛R可通过调节炎症介质发挥镇咳作用[21]；浙贝母有效成分具有止咳祛痰平喘、镇痛抗炎的功效[22]；麦冬具有肺保护作用，可减轻炎症反应，改善肺功能[23]。
AKT/mTOR信号通路是重要的细胞内信号传导通路，通过参与促进气道重塑、加速细胞衰老与调节自噬参与COPD的发生与发展[24]。本研究中，中药组患者治疗后AKT、p-AKT、mTOR、p-mTOR指标均低于常规组，表明肺康喘宁丸治疗慢性COPD迁延期肺肾气虚证可抑制AKT/mTOR信号通路，从而改善COPD症状，延缓疾病发展。有研究结果表明黄芪中所含黄芪甲苷等有效成分可通过阻断AKT/mTOR信号通路，抑制细胞自噬与凋亡、减轻气道炎症，具有肺保护作用[25-26]；五味子可阻断AKT/mTOR信号通路抑制气道重塑的发生[27]。
治疗过程中，两组患者均有发生呕吐、食欲减退等不良反应，但总发生率差异无统计学意义，且不良反应均为轻症，表明肺康喘宁丸治疗慢性COPD迁延期肺肾气虚证不会增加不良反应发生风险，安全性较高。
综上所述，肺康喘宁丸治疗慢性COPD迁延期肺肾气虚证可通过降低AKT/mTOR信号通路水平有效缓解临床症状，改善患者肺功能，疗效明确，值得临床推广。
基金
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  • 浙江省医药卫生科技计划项目(2022RC250)
  • 宁波市科技计划项目(2022S079)
  • 浙江中医药大学校级科研项目(2021FSYYEY07)
文献
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2025年第43卷第6期
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doi: 10.13193/j.issn.1673-7717.2025.06.038
  • 首发时间：2026-10-30
  • 出版时间：2025-06-10
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基金
浙江省医药卫生科技计划项目(2022RC250)
宁波市科技计划项目(2022S079)
浙江中医药大学校级科研项目(2021FSYYEY07)
作者信息
    宁波市中医院，浙江 宁波 315000

通讯作者:

杜学宏（1966-），男，甘肃张掖人，主任医师，学士，研究方向：中西医结合急危重症救治。
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.06.038
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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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